scholarly journals The Efficacy of Adjuvant Hysterectomy after Definitive Radiotherapy or Concurrent Chemoradiotherapy in Patients with Cervical Adenocarcinoma

2019 ◽  
Vol 105 (1) ◽  
pp. E330
Author(s):  
J. Ma ◽  
K. Hu ◽  
F. Zhang
Keyword(s):  
Concurrent Chemoradiotherapy ◽  
Cervical Adenocarcinoma ◽  
Definitive Radiotherapy ◽  
Adjuvant Hysterectomy

scholarly journals Propensity score-matched analysis of systemic chemotherapy versus salvage hysterectomy for persistent cervical cancer after definitive radiotherapy/concurrent chemoradiotherapy.

2020 ◽  
Author(s):  
MUNETAKA TAKEKUMA ◽  
Fumiaki Takahashi ◽  
Seiji Mabuchi ◽  
Wataru Kudaka ◽  
Koji Horie ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Propensity Score ◽  
Systemic Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Propensity Scores ◽  
Cohort Analysis ◽  
Residual Tumor ◽  
Oncologic Outcomes ◽  
Incomplete Resection ◽  
Definitive Radiotherapy

Abstract Background: The aim of the current study was to evaluate oncologic outcomes of patients who were treated with salvage hysterectomy (HT), compared to systemic chemotherapy (CT) for persistent cervical cancer after definitive radiotherapy (RT)/ concurrent chemoradiotherapy (CCRT).Methods: Patients with persistent cervical cancer treated with definitive RT/CCRT at 35 institutions from 2005–2014 were reviewed retrospectively (n = 317). Those who underwent a HT for persistent cervical cancer after definitive RT/CCRT were matched with propensity scores for patients who underwent systemic CT. Oncologic outcomes between the two groups using a propensity score matched–cohort analysis were compared.Results: A total of 142 patients with persistent cervical cancer after definitive RT/CCRT were included after matching (HT: 71, systemic CT: 71). All background factors between HT and CT groups were well balanced. Median overall survival was 3.8 and 1.5 years in the HT and CT groups, respectively (p= 0.00193, hazards ratio [HR] 0.41, 95% confidence interval [CI] 0.23–0.73), Increasing residual tumor size was significantly associated with a high incomplete resection rate (p = 0.016, Odds Ratio 1.11, 95%CI 1.02-1.22). Severe late adverse events occurred in 7 patients (9.9%) in the HT cohort.Conclusion: The current study demonstrated that, when compared to systemic CT, the adoption of salvage HT for patients with persistent cervical cancer after definitive RT/CCRT reduced mortality rate by about 60%. This indicates that salvage HT could be curative treatment for those patients. Further prospective clinical trials with regard to salvage HT after RT/CCRT are warranted.

scholarly journals Long-term Outcomes of Cervical Adenocarcinoma Treated With Concurrent Chemoradiotherapy Using Paclitaxel and Cisplatin

In Vivo ◽  
2020 ◽  
Vol 34 (5) ◽  
pp. 2739-2743
Author(s):  
YOSHIHISA ARAKAKI ◽  
TAKURO ARIGA ◽  
JOICHI HEIANNA ◽  
YUKO SHIMOJI ◽  
TADAHARU NAKASONE ◽  
...  
Keyword(s):  
Concurrent Chemoradiotherapy ◽  
Cervical Adenocarcinoma ◽  
Long Term Outcomes

scholarly journals The role of surgery following concurrent chemoradiotherapy in cervical adenocarcinoma

2020 ◽  
Author(s):  
Ke Hu ◽  
Jiabin Ma ◽  
Weiping Wang ◽  
Fuquan Zhang ◽  
Xiaorong Hou ◽  
...  
Keyword(s):  
Concurrent Chemoradiotherapy ◽  
Residual Disease ◽  
Progression Free Survival ◽  
Residual Tumor ◽  
Concurrent Chemotherapy ◽  
Cervical Adenocarcinoma ◽  
Free Survival ◽  
Surgery Group ◽  
Gynecology And Obstetrics ◽  
Local Progression

Abstract Purpose: To evaluate the clinical significance of adjuvant hysterectomy in patients with cervical adenocarcinoma (AC) primarily treated by definitive concurrent chemoradiotherapy (CCRT). Methods: We performed a retrospective analysis of cervical AC patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIIB in our hospital between Jan 2005 and Feb 2016. All patients were treated with external radiation(45-50.4Gy in 25 to 28 fractions) and brachytherapy (27-36Gy in 4 to 7 fractions), combined with concurrent chemotherapy including weekly cisplatin (40 mg/m 2 ) or weekly paclitaxel (75 mg/m 2 ). After CCRT, some patients received chemotherapy or hysterectomy, whereas the rest were followed up for observation. Survival outcomes were compared between patients who underwent hysterectomy after radiotherapy with those who did not. Results: A total of 109 cervical AC patients were enrolled. After a median follow-up duration of 48 months(range, 4-135 months), the 3-year overall survival (OS) and progression-free survival (PFS) were 82.3% and 57.8%, respectively. Fifty-two patients underwent hysterectomy after CCRT. The 3-year OS of surgery group was significantly higher than non-surgery group (68.6% vs. 52.8%, p =0.044). 3-year PFS, local progression-free survival (LPFS) and distant metastasis-free survival (DMFS) in surgery and non-surgery group were 59.1% vs. 44.7% ( p = 0.087), 87.6% vs. 66.3% ( p = 0.064) and 71.6% vs. 57.0% ( p =0.24), respectively. In subgroup analysis, hysterectomy significantly improved the 3-year PFS (54.1% vs. 18.8%, p =0.039) and 3-year DMFS (64.2% vs. 20.8%, p =0.030) in patients with residual tumor after CCRT, and had a trend in improving 3-year OS (62.8% vs. 37.5%, p =0.062) and 3-year LPFS (82.8% vs. 49.2%, p =0.082). Grade 3 or more late toxicities of urinary and gastro-intestinal systems in surgery and non-surgery groups were observed in 3.8% vs. 3.5%, and 1.9% vs.3.6% cases, respectively. Conclusion: Hysterectomy improved clinical outcomes of cervical AC patients with residual disease after CCRT. For patients with clinical complete response after CCRT, hysterectomy did not bring further survival benefit. The long-term toxicities of post-radiation surgery was tolerable.

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